Are Otolaryngologists Seeing More Cough? Longitudinal Trends and Patterns

Document Type

Article

Publication Date

9-26-2024

Abstract

Objective: Otolaryngologists play an increasing role in managing cough, but little data exists examining the demographics of this patient population and the referral patterns that influence their access to care. This study sought to elucidate these factors using a longitudinal, nationwide database to minimize sampling bias and identify trends representative of the national population. Study Design: Nationally representative survey. Setting: National Ambulatory Medical Care Survey (NAMCS). Methods: Visits with a diagnosis and chief complaint of cough between 2005 and 2019 in NAMCS were examined. Univariable and multivariable analyses were performed to compare patient demographics between visits to surgical specialists, medical specialists, and primary care physicians. Results: Otolaryngologists made up more than 84% of surgical specialist visits. There was a 0.52% [0.20%-0.84%] increase per year in the proportion of visits attributed to surgical specialists. Based on a sensitivity analysis of the multivariable model, Hispanic patients (adjusted odds ratio, aOR: 0.88 [0.78-0.99] vs White) and patients living outside of metropolitan areas (aOR: 0.77 [0.61-0.99] vs living within) were less likely to see surgical specialists than primary care doctors for their cough. Patients who were referred (aOR: 1.47 [1.28-1.72] vs not referred) and with chronic cough (aOR: 1.47 [1.23-1.75] vs acute/subacute) were more likely to see a surgical specialist. Conclusion: Otolaryngologists are increasingly called upon to evaluate and consider treatment for cough. Identifying patient groups with limited access underscores the need for enhanced education about otolaryngologists' roles and integrated care approaches to improve access to specialized cough treatment. Level of Evidence: Level 4.

Keywords

chronic cough, cough, demographics, epidemiology, laryngology, NAMCS

Language

English

Publication Title

Otolaryngology Head and Neck Surgery United States

Rights

© 2024 The Author(s). Otolaryngology–Head and Neck Surgery published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology– Head and Neck Surgery Foundation. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/BY-NC-ND/4.0/), which permits non-commercial copying and redistribution of the material in any medium or format, provided the original work is not changed in any way and is properly cited.

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